MEDICAL OFFICE BILLING

What does CPS provide as a part of the billing service?

CPS believes in a total concept. As part of our billing service agreement, we provide you with the practice management software,  initial set-up and training, continual local software support, follow-up training, report generation training and assistance in tailoring your processes to make the most effective use of the software for your practice. We have in-house nationally certified coders who can assist with coding questions or audits of documentation vs. coding assignment. We take the role of your advocate with payers if we feel their policies and procedures are not within the nationally accepted standards of claim processing or that your claim has been denied inappropriately.

Additionally, you should know the following about our billing service:

• Medical Office Billing , Collection and Accounts Receivable Management

• Over 12 years in the billing and AR management business

• Billing for 115+ providers in over 45 practices

• Our management staff has over 50 years of combined AR management experience

• All claims billed electronically

• We work with a nationally recognized clearinghouse to expedite claim payment

• Clearinghouse scrubs charges upon submission

• Over 50 percent of our claim payments are posted electronically

• Automated eligibility verification (AEV) the day before the patient visit

  • AEV for all major payers

  • Reduces eligibility denials

  • Increases front office collections

• Mobile charge capture

  • Award-winning mobile charge capture program to decrease charge submission delays

  • Front-end charge edits to check CPT to diagnosis validity or CPT to place of service

  • Front-end edits to check National Correct Coding Initiative (NCCI)

• Patient Encounter Form Scanning

  • Scanning program has complete charge edit package

  • Direct interface to billing system to eliminate charge posting errors and lag times

  • Information stored in a databank for analysis

• Rejections analyzed for denial patterns

  • Our follow-up and management personnel review denial patterns as part of our monthly analysis of unpaid or partially paid claims

  • Reports provided to practice management personnel

  • We work with payers on claim logic issues

• Monthly management reports

  • We provide a robust set of easy-to-read monthly practice management reports

  • We meet with you monthly/quarterly to review the reports to ensure clear understanding of the state of your Accounts Receivable

  • We assist you in analyzing the cost effectiveness of services you provide

  • We provide a summary by payer of all outstanding claim issues

• Complete medical office practice reviews and audits

• Practice consulting services

  • Process review of your workflow to ensure adequate internal controls are in place and that your staff is working at optimum efficiency

  • Audit charts to ensure documentation supports billed charges or that billed charges are reflective of services provided

  • Ensure compliance with federal programs and directives

• Consulting services on systems and procedures

  • Review practice management system to ensure maximum usage of system.